The Unique Challenges of Anxiety on the Autism Spectrum

A boy sits on bleachers with his head on his kneesOne of the most frustrating aspects of being on the autism spectrum is the constant anxiety that accompanies it. What does it mean to be on the spectrum and feel anxiety?

If you are not on the spectrum, it might be very difficult for you to even imagine what it is like because your experience is so different. To you, anxiety may be a fleeting sensation most often related to feeling uncertain or fearful. Once a situation is clarified or resolved, the anxiety associated with it typically wanes. You may return to your “normal” state and go on with your day.

Individuals on the spectrum, however, do not have the opportunity to return to a non-anxious state because their daily life is rife with the potential to surprise or confuse them. They live in a constant state of alertness because anything nuanced—and therefore unfamiliar—has the potential to be filled with traps for the unwary. They have had plenty of experience with saying or doing the wrong thing and paying the social consequences, so they are constantly alert to new possibilities for doing it again.

Since piecing together social experiences to create a template for future encounters is a cognitive process rather than an intuitive one, it can only take a person so far. Most of what we glean from an interpersonal communication is nonverbal, with some estimates for this as high as 70%. When you consider that the nonverbal is essentially invisible to a person on the spectrum, it is no surprise that anxiety would follow.

For example, facial expressions, body language, tone of voice, figures of speech, the physical distance between two people, innuendo, the cadence and inflection of speech, as well as its volume all provide information to neurotypical individuals which is not perceptible to those on the spectrum. In fact, many neurotypical people don’t realize how much communication is carried outside the actual spoken words. That is one of the reasons the anxiety of autism is such a difficult concept for people to grasp.

How You Can Help

What can you do to reassure someone who is on the spectrum? Can you help resolve some of this anxiety?

If it is someone you don’t know well, you can do your best to speak in concrete terms and to stick to one topic at a time. When you do change the topic in a conversation, try not to do it abruptly. Remember that humor often relies on wordplay, and that this can be elusive to a person on the spectrum. Be mindful that a lack of eye contact can mean that the person is trying very hard to follow what you are saying, and that the intensity of looking in your eyes at the same time may make that more difficult. Remember that it is not a conscious choice not to be socially adept. Be kind to those who appear not to be comfortable in social situations.

Any information about the secret codes and unwritten laws pertaining to communication in social situations that you can explain clearly to a person on the spectrum is likely to be met with confusion at first, and perhaps even incredulity. However, if you can help someone make sense of it, you will be providing a valuable piece of intelligence that might otherwise remain outside that person’s ability first to perceive and then to understand.

If it is a close friend or family member, you can have conversations that frankly discuss some of the otherwise inscrutable aspects of verbal and nonverbal communication. For example, a person I worked with in therapy was astonished to learn that the way members of the team at work seemed to make fun of each other was actually their way of demonstrating mutual appreciation and inclusiveness. To this person, the behavior appeared to be relentless badgering and ridicule until we discussed the underlying social conventions that had been invisible to him. He then came to see that his coworkers were behaving that way toward him as well. What had previously been experienced as hurtful now came to be seen as the language of group membership in that particular environment. His anxiety decreased significantly once this began to make sense to him. He decided he was not particularly comfortable in making an attempt at returning the behaviors in kind, because he wasn’t certain he could strike the right note in order to do so effectively, but he did develop a way of recognizing and receiving kidding from others without taking offense to it.

Any information about the secret codes and unwritten laws pertaining to communication in social situations that you can explain clearly to a person on the spectrum is likely to be met with confusion at first, and perhaps even incredulity. However, if you can help someone make sense of it, you will be providing a valuable piece of intelligence that might otherwise remain outside that person’s ability first to perceive and then to understand.

The greatest gift you can provide is your awareness of how exhausting it is for a person on the spectrum to navigate the neurotypical world all day long. Respecting the need for private time to decompress after a long day of living in an alien culture and speaking a confusing language requires restful, quiet interludes for recalibration and peace of mind.

Anxiety is part of being on the spectrum. Your understanding of this can help relieve it. Remember, though, that it will never completely go away.


  1. Ekman, P. (2007). Emotions revealed. New York, NY: St. Martin’s Griffin.
  2. Ekman, P., & Friesen, W. V. (2003). Unmasking the face. Cambridge, MA: Malor Books.
  3. Meherabian, A. (2007). Nonverbal communication. Piscataway, New Jersey: Aldine Transaction.

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Deanna


    January 5th, 2016 at 9:43 AM

    I would feel so bad for any family having to live with this double whammy of anxiety and autism. That must be extremely difficult especially because there will be times when the coping skills would not be there to be able to deal with that, and that could cause even more anxiety.

  • Jay


    January 6th, 2016 at 8:23 AM

    so I wonder is there anything that helps identify what the primary diagnosis is, and then if the anxiety then begins as a result of that or is it just something that is concurrent in some patients?

  • claira


    January 6th, 2016 at 2:43 PM

    There are so many different ways that those of us who do not live on the autism spectrum to help out with those who do… but it can be a challenge when we struggle with understanding the very real fears and anxieties that many of them live with and are surrounded by every day.

  • Tripp


    January 8th, 2016 at 9:51 AM

    Thank you so much for always giving needed attention to this community and their famileis which are so often overlooked.

  • Rowena


    January 12th, 2016 at 2:47 PM

    I worry so much about the miscues that my son reads and gives off as he is on the autistic spectrum. He is pretty good with most people, but you know he just has that lack of affect that people often use to read into words so I think that there is a lot that goes without saying that probably is never interpreted the right way. I do what I can to help him get through this world that can be so mean, but you know, I can only be there part of the time and the rest of the time I just hope that what we have done and how we have prepared him will be enough.

  • davis h

    davis h

    January 13th, 2016 at 3:04 PM

    Any time there is a concurrent thing that goes together, and in these cases anxiety and autism, it can make things so much more difficult and address than it would be if you were only dealing with one specific thing.

  • Sarah Swenson, MA, LMHC

    Sarah Swenson, MA, LMHC

    January 22nd, 2016 at 5:45 PM

    I agree that the challenges are greater when combined. It’s impossible to separate high-functioning autusm and anxiety because of the pressures associated with a primarily cognitive approach to life, and the high risk of making an error of judgment.

  • Okwuchukwu treasurer's

    Okwuchukwu treasurer's

    February 3rd, 2016 at 11:11 PM

    I’m a student in college of education studying educational psychology. Watching all your write ups i can really say that I’m impress, so I will like to know more about it. Because presently i work with children with autism (special need) in an institution (the zamarr institute). Thanks

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Title   Content   Author is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on